It sounds like this policy is being met with a ton of backlash from all advocacy groups. What we definitely don't want to do is discourage anyone (with any diagnosis) to not seek emergency care if they need it. I can imagine this is very worrisome for our community.

DAJ,

I agree we should write to our representatives. If United healthcare institutes the policy all other insurers are sure to follow.

Franny

You're right, Franny. If United Healthcare gets away with this restriction on the ER claims, the other insurance companies will follow. I personally am going to write to my representatives. I hope others will as well. If we do nothing, our benefits will get reduced causing our medical expenses to go up while our medical care goes down. .

It is just so unfair. Some doctors who review the claims may view the concerns of respiratory patients as emergent - those who fully understand the biopsychosocial concerns of NTM/ bronchiectasis patients whereas other doctors will view the claims as non emergent since they do not understand the disorder and impact on the lives of many patients. We must get the message to the insurance companies and state representatives.

I have that for my insurance hope someone gets in there and changes this. I did look through the states and SD and ND are not listed.

Anthem began its policy of denying non-emergency ED visits in 2017 here in Kentucky. It came about because people have been using emergency rooms for non-emergency purposes for decades. ER's are treating patients who come in due to a blister or a tooth ache and other unwarranted visits which cost health plans billions of dollars per year.

 Even if an emergency department visit is denied, a study in 2018 showed when people appealed their emergency claims that Anthem had denied, the majority of those appeals were successful.

The vast majority of emergency room claims are paid by the insurer. Visits to an emergency room for a lung issue wouldn't be denied. (I'm an ex-insurance broker)

The bestest news is effective January 1, 2022, a federal law takes effect which protects consumers against unexpected medical bills, commonly referred to as balance billing. The Act contains provisions that prohibit providers, facilities and health insurance companies from holding patients liable for emergency services and certain non-emergency services beyond the patient’s in-network cost-sharing amount.

Anthem began its policy of denying non-emergency ED visits in 2017 here in Kentucky. It came about because people have been using emergency rooms for non-emergency purposes for decades. ER's are treating patients who come in due to a blister or a tooth ache and other unwarranted visits which cost health plans billions of dollars per year.

 Even if an emergency department visit is denied, a study in 2018 showed when people appealed their emergency claims that Anthem had denied, the majority of those appeals were successful.

The vast majority of emergency room claims are paid by the insurer. Visits to an emergency room for a lung issue wouldn't be denied. (I'm an ex-insurance broker)

The bestest news is effective January 1, 2022, a federal law takes effect which protects consumers against unexpected medical bills, commonly referred to as balance billing. The Act contains provisions that prohibit providers, facilities and health insurance companies from holding patients liable for emergency services and certain non-emergency services beyond the patient’s in-network cost-sharing amount.

Anthem began its policy of denying non-emergency ED visits in 2017 here in Kentucky. It came about because people have been using emergency rooms for non-emergency purposes for decades. ER's are treating patients who come in due to a blister or a tooth ache and other unwarranted visits which cost health plans billions of dollars per year.

 Even if an emergency department visit is denied, a study in 2018 showed when people appealed their emergency claims that Anthem had denied, the majority of those appeals were successful.

The vast majority of emergency room claims are paid by the insurer. Visits to an emergency room for a lung issue wouldn't be denied. (I'm an ex-insurance broker)

The bestest news is effective January 1, 2022, a federal law takes effect which protects consumers against unexpected medical bills, commonly referred to as balance billing. The Act contains provisions that prohibit providers, facilities and health insurance companies from holding patients liable for emergency services and certain non-emergency services beyond the patient’s in-network cost-sharing amount.

Anthem began its policy of denying non-emergency ED visits in 2017 here in Kentucky. It came about because people have been using emergency rooms for non-emergency purposes for decades. ER's are treating patients who come in due to a blister or a tooth ache and other unwarranted visits which cost health plans billions of dollars per year.

 Even if an emergency department visit is denied, a study in 2018 showed when people appealed their emergency claims that Anthem had denied, the majority of those appeals were successful.

The vast majority of emergency room claims are paid by the insurer. Visits to an emergency room for a lung issue wouldn't be denied. (I'm an ex-insurance broker)

The bestest news is effective January 1, 2022, a federal law takes effect which protects consumers against unexpected medical bills, commonly referred to as balance billing. The Act contains provisions that prohibit providers, facilities and health insurance companies from holding patients liable for emergency services and certain non-emergency services beyond the patient’s in-network cost-sharing amount.

Anthem began its policy of denying non-emergency ED visits in 2017 here in Kentucky. It came about because people have been using emergency rooms for non-emergency purposes for decades. ER's are treating patients who come in due to a blister or a tooth ache and other unwarranted visits which cost health plans billions of dollars per year.

 Even if an emergency department visit is denied, a study in 2018 showed when people appealed their emergency claims that Anthem had denied, the majority of those appeals were successful.

The vast majority of emergency room claims are paid by the insurer. Visits to an emergency room for a lung issue wouldn't be denied. (I'm an ex-insurance broker)

The bestest news is effective January 1, 2022, a federal law takes effect which protects consumers against unexpected medical bills, commonly referred to as balance billing. The Act contains provisions that prohibit providers, facilities and health insurance companies from holding patients liable for emergency services and certain non-emergency services beyond the patient’s in-network cost-sharing amount.

Anthem began its policy of denying non-emergency ED visits in 2017 here in Kentucky. It came about because people have been using emergency rooms for non-emergency purposes for decades. ER's are treating patients who come in due to a blister or a tooth ache and other unwarranted visits which cost health plans billions of dollars per year.

 Even if an emergency department visit is denied, a study in 2018 showed when people appealed their emergency claims that Anthem had denied, the majority of those appeals were successful.

The vast majority of emergency room claims are paid by the insurer. Visits to an emergency room for a lung issue wouldn't be denied. (I'm an ex-insurance broker)

The bestest news is effective January 1, 2022, a federal law takes effect which protects consumers against unexpected medical bills, commonly referred to as balance billing. The Act contains provisions that prohibit providers, facilities and health insurance companies from holding patients liable for emergency services and certain non-emergency services beyond the patient’s in-network cost-sharing amount.

I agree that a lot of people do go to the ER with non-emergency problems.  I think that doctors are also partially responsible for this because, of the doctors I have called, most of them tell you to call 911 or go to the ER if you have a problem.  My Primary has actually changed her recording now, urging patients to call them first before going to the ER.  Her nurse told me that the insurance carriers are trying to get rid of primary doctors and want people to go to Urgent Care instead.  The bigger concern is that if United Healthcare or any other insurer issues a "blanket restriction" to deny ER non-emergency claims, they can refuse to pay them all, and THEY are the ones who decide what is non-emergency.  I don't trust them to do that.  I have done several appeals and have not had any approved even when they told me up front before getting treatment that it would be paid.  

I agree that a lot of people do go to the ER with non-emergency problems.  I think that doctors are also partially responsible for this because, of the doctors I have called, most of them tell you to call 911 or go to the ER if you have a problem.  My Primary has actually changed her recording now, urging patients to call them first before going to the ER.  Her nurse told me that the insurance carriers are trying to get rid of primary doctors and want people to go to Urgent Care instead.  The bigger concern is that if United Healthcare or any other insurer issues a "blanket restriction" to deny ER non-emergency claims, they can refuse to pay them all, and THEY are the ones who decide what is non-emergency.  I don't trust them to do that.  I have done several appeals and have not had any approved even when they told me up front before getting treatment that it would be paid.  

I agree that a lot of people do go to the ER with non-emergency problems.  I think that doctors are also partially responsible for this because, of the doctors I have called, most of them tell you to call 911 or go to the ER if you have a problem.  My Primary has actually changed her recording now, urging patients to call them first before going to the ER.  Her nurse told me that the insurance carriers are trying to get rid of primary doctors and want people to go to Urgent Care instead.  The bigger concern is that if United Healthcare or any other insurer issues a "blanket restriction" to deny ER non-emergency claims, they can refuse to pay them all, and THEY are the ones who decide what is non-emergency.  I don't trust them to do that.  I have done several appeals and have not had any approved even when they told me up front before getting treatment that it would be paid.  

I agree that a lot of people do go to the ER with non-emergency problems.  I think that doctors are also partially responsible for this because, of the doctors I have called, most of them tell you to call 911 or go to the ER if you have a problem.  My Primary has actually changed her recording now, urging patients to call them first before going to the ER.  Her nurse told me that the insurance carriers are trying to get rid of primary doctors and want people to go to Urgent Care instead.  The bigger concern is that if United Healthcare or any other insurer issues a "blanket restriction" to deny ER non-emergency claims, they can refuse to pay them all, and THEY are the ones who decide what is non-emergency.  I don't trust them to do that.  I have done several appeals and have not had any approved even when they told me up front before getting treatment that it would be paid.  

I agree that a lot of people do go to the ER with non-emergency problems.  I think that doctors are also partially responsible for this because, of the doctors I have called, most of them tell you to call 911 or go to the ER if you have a problem.  My Primary has actually changed her recording now, urging patients to call them first before going to the ER.  Her nurse told me that the insurance carriers are trying to get rid of primary doctors and want people to go to Urgent Care instead.  The bigger concern is that if United Healthcare or any other insurer issues a "blanket restriction" to deny ER non-emergency claims, they can refuse to pay them all, and THEY are the ones who decide what is non-emergency.  I don't trust them to do that.  I have done several appeals and have not had any approved even when they told me up front before getting treatment that it would be paid.  

I agree that a lot of people do go to the ER with non-emergency problems.  I think that doctors are also partially responsible for this because, of the doctors I have called, most of them tell you to call 911 or go to the ER if you have a problem.  My Primary has actually changed her recording now, urging patients to call them first before going to the ER.  Her nurse told me that the insurance carriers are trying to get rid of primary doctors and want people to go to Urgent Care instead.  The bigger concern is that if United Healthcare or any other insurer issues a "blanket restriction" to deny ER non-emergency claims, they can refuse to pay them all, and THEY are the ones who decide what is non-emergency.  I don't trust them to do that.  I have done several appeals and have not had any approved even when they told me up front before getting treatment that it would be paid.